Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024;11(4):1047-1054.
doi: 10.14283/jpad.2024.51.

Association between Comorbidity Indices and Functional Autonomy in Individuals with Cognitive Impairment: A Systematic Review

M N Temedda  1 , A Garnier-Crussard, C Mouchoux, V Dauphinot
Affiliations

Association between Comorbidity Indices and Functional Autonomy in Individuals with Cognitive Impairment: A Systematic Review

M N Temedda et al. J Prev Alzheimers Dis. 2024.

Abstract

This systematic review aimed to examine whether higher comorbidity burden, as assessed by comorbidity indices, was associated with a functional autonomy decline in individuals with cognitive impairment. The search was conducted in the following databases: PubMed/MEDLINE, ScienceDirect, Cochrane, and Embase. Both cross-sectional and longitudinal studies that examined the relationship between comorbidity indices and scales measuring activities of daily living (ADL) in individuals with cognitive impairment were included. The quality assessment tool for observational cohort and cross-sectional studies of the National Institutes of Health (NIH) was used. Overall, 12 studies were included, among which three were longitudinal. Significant association was frequently reported by cross-sectional designs (n=7 studies) and only one study reported a significant longitudinal association. This longitudinal study repeatedly assessed both comorbidity burden and functional autonomy, and considered comorbidity burden as a time-varying covariate. Considering comorbidity burden as a time varying covariate may deal with the dynamic nature of comorbidity burden over time, and conducting repeated assessments during the follow-up using both comorbidity index and ADL scales may increase their sensitivity to reliably measure comorbidity burden and functional autonomy decline over time. In conclusion, a higher comorbidity index was associated with a lower level of functional autonomy in people with cognitive impairment. This relationship seems to be dynamic over time and using comorbidity indices and ADL scales only once may not deal with the fluctuation of both comorbidity burden and functional autonomy decline. To cope with complexity of this relationship this review highlights some methodological approaches to be considered.

Keywords: Comorbidity burden; cognition; comorbidity index; dementia; functional autonomy decline.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests; this manuscript has not been published or submitted elsewhere. All authors have contributed significantly, and all authors are in agreement with the content of the manuscript.

Figures

Figure 1
Figure 1
Flow Chart
See this image and copyright information in PMC

References

    1. The Lancet Public Health Reinvigorating the public health response to dementia. Lancet Public Health. 2021;6(10):e696. 10.1016/S2468-2667(21)00215-2 PubMed PMID: 34563278; PMCID 8516159. - DOI - PMC - PubMed
    1. Chen TB, Yiao SY, Sun Y, et al. Comorbidity and dementia: A nationwide survey in Taiwan. PLOS ONE. 2017;12(4) 10.1371/journal.pone.0175475 PubMed PMID: 28403222; PMCID 5389824. - DOI - PMC - PubMed
    1. Poblador-Plou B, Calderón-Larrañaga A, Marta-Moreno J, et al. Comorbidity of dementia: a cross-sectional study of primary care older patients. BMC Psychiatry. 2014;14:84. 10.1186/1471-244X-14-84 PubMed PMID: 24645776; PMCID 3994526. - DOI - PMC - PubMed
    1. Kao SL, Wang JH, Chen SC, Li YY, Yang YL, Lo RY. Impact of Comorbidity Burden on Cognitive Decline: A Prospective Cohort Study of Older Adults with Dementia. Dement Geriatr Cogn Disord. 2021;50(1):43–50. 10.1159/000514651 PubMed PMID: 33789290. - DOI - PubMed
    1. Vance D, Larsen KI, Eagerton G, Wright MA. Comorbidities and cognitive functioning: implications for nursing research and practice. J Neurosci Nurs. 2011;43(4):215–224. 10.1097/JNN.0b013e3182212a04 PubMed PMID: 21796044. - DOI - PubMed

Publication types

LinkOut - more resources